Mecklenburg   EMS   Agency   (Medic)
Joe   Penner
BOARD   OF   COUNTY   COMMISSIONERS   ANNUAL   RETREAT
◦ Medic   serves   as   the   Emergency   Medical   Service   (EMS) provider   for   all   of   Mecklenburg   County
◦ As   a   high   performance   EMS   system,   Medic   is   data   driven and   outcome   focused
◦ Medic   treats   and   transports   all patients   regardless   of their   ability   to   pay
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◦ The   average   bill   for   service   is   currently   $1,042
◦ Demand   for   Medic’s   services   is   increasing   at   twice   the   rate   of
Mecklenburg   County’s   population
◦ Medic   forecasts   that   108,165   patients   will   be   treated   and transported   in   FY   ’16
◦ 7%   higher   than   FY   ’15
◦ 13%   higher   than   FY   ‘14
140,000
120,000
100,000
80,000
60,000
40,000
20,000
-
FY '05 FY '06 FY '07 FY '08 FY '09
Transports
FY '10 FY '11
Responses
FY '12 FY '13 FY '14 FY '15
90-40

Non-
Emergency
Transport,
16,932
Life
Threatening,
4,668
Potentially Life
Threatening,
11,329
Non-Life
Threatening,
68,172
Goal:   Reduce   Demand   for   Service   on   Medic
◦ Objective   1:   Identify   tactics   to   safely   reduce   unnecessary   use of   the   911   system   by   10%
◦ Analyze   existing   data   to   identify   low   risk   conditions   for inclusion
◦ Develop   strategies   for   safely   identifying   such   patients
◦ Engage   community   partners   to   establish   alternative   care options
◦ Analyze   the   financial   impact   to   Medic
◦ Run   tests   for   continued   learning   and   program   refinement
◦ At   no   time   would   a   patient   be   denied   transport;   they   would be   informed   of   their   options
90-41

Goal:   Reduce   Demand   for   Service   on   Medic
◦ Objective   1:   Identify   tactics   to   safely   reduce   unnecessary use   of   the   911   system   by   10%
◦ The   impact   of   reducing   unnecessary   use   of   the   911 system   could   be   significant
◦ Increase   unit   availability   for   patients   with   acute   health issues
◦ Decrease   the   number   of   patients   saddled   with   a   large, unnecessary   bill
◦ Decrease   the   rate   of   necessary   staff   increases   for   Medic
◦ Connect   more   people   with   the   appropriate   level   of   care
Goal:   Reduce   Demand   for   Service   on   Medic
◦ Objective   2:   Reduce   reliance   on   the   911   system   by frequent   users   by   38%
◦ Between   1/1/15   and   11/30/15   Medic   transported   308 high   frequency   patients   a   total   of   10,129   times
◦ 9,059   of   these   transports   (90%)   were   non ‐ emergent
◦ Medic   has   been   working   with   key   partners   in   the community   to   better   help   these   people
◦ A   trial   program   that   began   in   May   of   2015   yielded   a
59%   reduction   in   transports   for   ten   high   frequency patients
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Goal:   Reduce   Demand   for   Service   on   Medic
◦ Objective   2:   Reduce   reliance   on   the   911   system   by frequent   users   by   38%
◦ The   program   is   still   developing;   discussions   on   how   to improve   continue
◦ There   are   currently   16   patients   in   the   program   who average   4   transports   each   per   month
◦ The   primary   benefit   of   this   initiative   is   improved quality   of   life   for   the   people   impacted
◦ Medic   benefits   from   improved   resource   availability for   patients   with   acute   health   issues
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Mecklenburg   EMS   Agency   (Medic)
Joe   Penner
BOARD   OF   COUNTY   COMMISSIONERS   ANNUAL   RETREAT
90-44

Marcus   Plescia,   MD,   MPH
BOARD   OF   COUNTY   COMMISSIONERS   ANNUAL   RETREAT
Community   Priorities:
1. Chronic   Disease 2. Mental   Health 3. Violence   Prevention
Leading   Causes   of   Death   in   Mecklenburg   County:
1. Cancer 2. Heart   Disease 3. Alzheimer’s   Disease
Top   Health   Disparities   in   Mecklenburg   County:
1. HIV 2. Diabetes 3. Birth   Outcomes
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Smallest
Impact
Greatest
Impact
Counseling & Education
Clinical
Interventions
Long-lasting Protective
Interventions
Changing the Context
Eat healthy, be physically active
Taking prescriptions
Immunizations,
Colonoscopy
Smoke-free laws,
Fluoridation
Socioeconomic Factors
Changing   the   context   for   community   health   &   wellness.
Impact poverty, education, inequality
Objective   1:   Chang   social   norms   and   assure   access   to   care
◦ HIV/AIDS
Objective   2:    Meet   the   needs   of   a   growing   community
◦ Environmental   Health
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Persons   aged   13 ‐ 24   living   with   HIV   Diagnosis
HIV/AIDS   (Objective   1)
0 ‐ 124
125 ‐ 187
188 ‐ 254
255 ‐ 345
346 ‐ 460
461 ‐ 631
632 ‐ 884
*Data   not   shown
Source:   AIDSvu,   http://aidsvu.org/map/?state=NC
Objective   1   &   2:   Make   it   easy   to   adopt   healthy   behaviors
• Tobacco   Control,   Physical   Activity   and   Nutrition
Objective   3:   Assure   access   to   contraception   after   birth
• Unintended   Pregnancies
90-47

Food   Access   (Objective2)
Receive   Family   Planning   in   post ‐ partum   period:
Medicaid   patients
39.0%
37.0%
35.0%
33.0%
31.0%
29.0%
27.0%
25.0%
Apr   to   Jun   2013
State
Jul   to   Sep   2013 Oct   to   Dec   2013 Jan   to   Mar   2014 Apr   to   Jun   2014
Community   Care   Partners   of   Greater   Mecklenburg
Jul   to   Sep   2014
Peer
Oct   to   Dec   2014
Group  ‐
Jan   to   Mar   2015
Metropolitan
Unintended   Pregnancies   (Objective   3)
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Goal   3:   Improve   monitoring   and   increase   access   to   resources   and   care   that   address   health   disparities
Objectives   2   &   3:   Support   a   comprehensive   school   health   model
• Child   &   School   Health
Objectives   5,   6,   &   7:   Expand   evidence   based   programs   with   law   enforcement
• Violence   Prevention
Child   &   School   Health   (Objectives   2   &   3)
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Tobacco   Control,   Physical   Activity   and   Nutrition   (Objective   1&2)
90-50

Percent   of   Women   Receiving   Long   Acting   Reversible   Contraceptives   (LARCs)
Within   60   Days   After   Giving   Birth   (per   Medicaid   reimbursement   data)
16.0%
15.0%
14.0%
13.0%
12.0%
11.0%
10.0%
9.0%
8.0%
7.0%
6.0%
Apr   to   Jun   2013
State
Jul   to   Sep   2013 Oct   to   Dec   2013 Jan   to   Mar   2014 Apr   to   Jun   2014
Community   Care   Partners   of   Greater   Mecklenburg
Jul   to   Sep   2014
Peer
Oct   to   Dec   2014
Group  ‐
Jan   to   Mar   2015
Metropolitan
Unintended   Pregnancies   (Objective   3)
Marcus   Plescia,   MD,   MPH
BOARD   OF   COUNTY   COMMISSIONERS   ANNUAL   RETREAT
90-51

Park   &   Recreation
Community   Health   &   Wellness
Jim   Garges,   Director
BOARD   OF   COUNTY   COMMISSIONERS   ANNUAL   RETREAT
11.7M
Park   Visits
By   Residents   in   FY14
(not   including   tourists) 215+   Parks,   Preserves,   and   Facilities
74%   of   Households
Utilize   Parks
30%   Less
FT   Staff   than   FY10
22   New
Parks   Opened   since   FY10
500+   Athletic   Fields
&   Courts
10%+   Population   Growth
Increasing   Visitation
90-52

Park   Conditions
Visitor   Satisfaction
92
90
88
86
84
82
80
FY13 FY14 FY15
Greatest   Needs with
by   #   of   Households
Demand
262,604
226,745 226,021
186,540 165,895 160,460 160,098 159,114
Awareness   of   Facilities
40
30
20
60
50
10
0
FY10 FY11 FY12 FY13 FY14
*As   of   December   31,   2015
Goal   1:   Increase the   availability   of   fitness   and   wellness programs   and   awareness   of   facilities   and   services.
Objective   1:   Expand   and   provide   target   fitness   and   wellness   programs   to   help   residents   improve   and   maintain   their   health
90-53

Goal   1:   Increase the   availability   of   fitness   and   wellness programs   and   awareness   of   facilities   and   services.
Objective   2:   Develop   initiatives   to   promote   programs   and   increase   public   awareness   of   department   services   and   facilities
40
30
20
60
50
10
0
Goal   1:   Increase the   availability   of   fitness   and   wellness programs   and   awareness   of   facilities   and   services.
Objective   2:   Develop   initiatives   to   promote   programs   and   increase   public   awareness   of   department   services   and   facilities
Awareness   of   Facilities Ray’s   Splash   Planet   Revenues
$660,000
$640,000
$620,000
$600,000
$580,000
$560,000
$540,000
$520,000
$500,000
FY10 FY11 FY12 FY13 FY14 FY09 FY10 FY11 FY12 FY13 FY14
90-54

Goal   1:   Increase the   availability   of   fitness   and   wellness programs   and   awareness   of   facilities   and   services.
Objective   2:   Develop   initiatives   to   promote   programs   and   increase   public   awareness   of   department   services   and   facilities
Daily   Admissions   Up   32%
3,500
3,000
2,500
2,000
1,500
1,000
500
0
FY15
Nov/Dec
Daily
Admissions
FY16
Nov/Dec
Daily
Admissions
Revenue   Up   24%   or   $10,956
$60,000
$50,000
$40,000
$30,000
$20,000
$10,000
$0
FY15
Nov/Dec
Revenue
FY16
Nov/Dec
Revenue
Initial   Results:
Within   6   weeks   of
Marketing   Initiative,   36%     of   the   upfront   cost   has   been   recouped   and   admissions   increased.
Marketing   initiative   continues   for   2   more   months.
90-55
Park   &   Recreation
Community   Health   &   Wellness
Jim   Garges,   Director
BOARD   OF   COUNTY   COMMISSIONERS   ANNUAL   RETREAT

Land   Use   and   Environmental   Services   Agency   (LUESA)
FY2017   – 2019   Strategic   Business   Plan
Ebenezer   S.
Gujjarlapudi,   P.E.
BOARD   OF   COUNTY   COMMISSIONERS   ANNUAL   RETREAT
Six   Divisions
◦ Air   Quality ‐ “Attainment”   status   for   Ozone   in   August   2015
◦ Code   Enforcement   – over   94k   permits   and   265k   inspections   in   2015
◦ Geospatial   Information   Services   (GIS) – 36   mil   sq.
ft.
of   billed   impervious   data
◦ Water   and   Land   Resources – 76.1%   streams   suitable   for   human   contact   (25%   in   1998)
◦ Solid   Waste – coordinated   disposal   of   over   500k   tons   of   waste
◦ Support   Services   – coordinated   move   to   Suttle Ave
Served   over   1   million   customers   in   FY2015
90-56

‐
Goal   1:     Ensure   Cost   Effective   Long ‐ Term   Solutions   for
Solid   Waste   Management
Goal   2:     Enhance   Quality   of   Life   through   Environmental
Stewardship
Goal   3:     Maintain   Environmental   Sustainability   of   Operations
‐
Goal   1:     Ensure   Cost   Effective   Long ‐ Term   Solutions   for
Solid   Waste   Management
Goal   2:     Enhance   Quality   of   Life   through   Environmental
Stewardship
Goal   3:     Maintain   Environmental   Sustainability   of   Operations
90-57

Goal   1:   Ensure   Cost   Effective   Long ‐ Term
Solutions   for   Solid   Waste   Management
Background   and   Rationale:
• Interlocal agreements   until   2028
• Speedway   Landfill   contract   expires   2020
• Material   Recovery   Facility   (MRF)   contract   expires   2019
• 350,000+   tons   at   Speedway
• 100,000+   tons   at   the   MRF
• 80,000+   tons   of   Construction   &   Demolition   Debris   at   Foxhole
~180,000   TPY
Residential   Recycling
(Cans,   Bottle,   paper,   etc.)
Residential   &   Commercial
Waste
MSW   “Trash”
~375,000   tons/yr
~76,000   TPY
Meck   tons
~26,000   TPY
Salisbury   tons
Republic   (BFI)
MSW   LANDFILL
MSW   “Trash”
Meck   County   Material   Recycling
Facility
Residential   &   Commercial   Grass/Leaves
Compost   Facility
Meck   Co   Owned   Operated
Finished   Compost   &
Ground   Mulch
Is   Sold   $$
Yard   Waste
Non   Municipal   Participants
Various   Privately   Owned
Recycling   &   Waste   Facilities
Meck   County   Drop ‐ Off
Centers
(Recycling   &   Trash)
Mostly   Commercial   Construction   &
Demolition   Waste
C   &   D   Waste
~26,000   TPY
~80,000   TPY
FOXHOLE   Landfill
Construction   &   Demo
Waste
=   Private
=   Meck   County
Owned
90-58

Ensure   Cost   Effective   Long ‐ Term
Solutions   for   Solid   Waste   Management
Objective   1:
Review   operating   agreements   to   ensure   long   term   waste   disposal   and   recycling   opportunities
Ensure   Cost   Effective   Long ‐ Term   Solutions   for   Solid   Waste   Management
Background   and   Rationale:
• Impact   of   commodity   markets   on current   practices
• Opportunities   to   enhance   recovery of   some   recyclables
90-59

Ensure   Cost   Effective   Long ‐ Term   Solutions   for   Solid   Waste   Management
Objective   2:
Seek   cost   effective   environmental   solutions   towards   waste   reduction,   reuse   and   recycling
Ensure   Cost   Effective   Long ‐ Term   Solutions   for   Solid   Waste   Management
Background   and   Rationale:
• Four   full ‐ service   centers
• Eight   self   service   centers
• Increased   customer   numbers
• Movement   of   materials between   locations
• Opportunities   for   Public/Private partnerships
90-60

Facility   Improvements   and   Enhancements
One   example   is   installation   of   Scales   at   all   Solid
Waste   Facilities   to   accurately   charge   customers
Ensure   Cost   Effective   Long ‐ Term   Solutions   for   Solid   Waste   Management
Objective   3:
Evaluate   and   update   infrastructure   necessary   for   waste   acceptance   and   processing
90-61

‐
Goal   1:     Ensure   Cost   Effective   Long ‐ Term   Solutions   for
Solid   Waste   Management
Goal   2:     Enhance   Quality   of   Life   through   Environmental
Stewardship
Goal   3:     Maintain   Environmental   Sustainability   of   Operations
Goal   2:   Enhance   Quality   of   Life   through
Environmental   Stewardship
Background   and   Rationale:
◦ Six   monitoring   sites   – State   Review   Session   Law   2015 ‐ 286
◦ Mecklenburg   County   meets   the   National   Ambient   Air   Quality   Standards
◦ State   Review   of   “Gasoline   Tax”   funding   – Impact   on   GRADE   performance
◦ State   Review   of   Environmental   Regulations
90-62

Ozone Air Quality, 1999-2015
Mecklenburg County 8-hour Design Value Concentration
Based on Annual 4th Maximum 8-hour Average
100
75
50
25
0
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Mecklenburg Compliance Value 2008 NAAQS 2015 NAAQS
90-63

Enhance   Quality   of   Life   through
Environmental   Stewardship
Objective   1:
Improve   and   maintain   healthy   air   quality
Enhance   Quality   of   Life   through
Environmental   Stewardship
Background   and   Rationale:
◦ Creek   Use   Policy  ‐ Adopted   October   16,   1996
◦ Primarily   impacted   by   fecal   coliform
◦ FY   2015   performance   – 76.1%   vs.
goal   of   85%   by   2020   (25%   in   1998)
◦ Continuous   monitoring   of   30   stream   sites
◦ Stream   walks   of   280   miles   in   FY2015
◦ Removal   of   over   10   tons   of   trash   and   debris
90-64

Enhance   Quality   of   Life   through
Environmental   Stewardship
Objective   2:
Continue   progress   to   make   all   waters   suitable   for   prolonged   human   contact
Enhance   Quality   of   Life   through
Environmental   Stewardship
Background   and   Rationale:
◦ Pilot   retroFIT   program   – Adopted   August   4,   2015
◦ Flood   mitigation   program   – purchase   of   over   370   properties
◦ Stream   restoration   projects   in   collaboration   with
Mecklenburg   County   Parks   and   Recreation   Department
90-65

FY2015   – First   Grant   Cycle  ‐ Closed   November   30,   2015
79 INTEREST   APPLICATIONS
D RY F LOODPROOFING
S ERVICE E QUIPMENT
E LEVATION
W ET F LOODPROOFING
D EMOLITION
R ELOCATION
A BANDON B ASEMENT
0
2
7
8
10
38
40
39
49
20 30 40 50
#   of   Preferred   Techniques
60 70 80
90-66

Torrence   Creek   –
McDowell   Creek   Watershed
Enhance   Quality   of   Life   through
Environmental   Stewardship
Objective   3:
Prevent   loss   of   life   and   property   from   flooding
90-67

‐
Goal   1:     Ensure   Cost   Effective   Long ‐ Term   Solutions   for
Solid   Waste   Management
Goal   2:     Enhance   Quality   of   Life   through   Environmental
Stewardship
Goal   3:     Maintain   Environmental   Sustainability   of   Operations
Goal   3:   Maintain   Environmental
Sustainability   of   Operations
Background   and   Rationale:
◦ Encourage   use   of   recycled   paper,   environmentally   friendly   office   and cleaning   supplies,   recycled   printer   cartridges
◦ Promote   mass   transit,   car   pooling,   telecommuting,   cycling   etc.,   as potential   opportunities
◦ Foster   a   culture   of   responsible   use   of   natural   resources
90-68

Maintain   Environmental   Sustainability   of
Operations
Objective   1:
Adhere   to   Environmentally   Preferable   Purchasing   (EPP)   guidelines
Objective   2:
Provide   employees   with   opportunities   to   learn   about   and   practice   environmentally ‐ friendly   activities
‐ Work   Green   Program
90-69

Land   Use   and   Environmental   Services   Agency   (LUESA)
FY2017   – 2019   Strategic   Business   Plan
Ebenezer   S.
Gujjarlapudi,   P.E.
BOARD   OF   COUNTY   COMMISSIONERS   ANNUAL   RETREAT
90-70